Workers Compensation Specialist
Posted on 6/1/2022
- BS/BA degree or 2-5 years applicable experience in Workers Compensation and Claim Management
- Bachelor's degree preferred
- Demonstrated knowledge of workers' compensation claims management related laws and medical and legal terminology
- Multi-state workers' compensation or related field exposure
- Associates in Risk Management or other insurance/claim related designations
- History of process improvement exposure, as a leader or participant
- High comfort with managing and communicating claim trends and information by using various data sources
- Excellent verbal communication skills and a positive approach to customer interactions
- Ability to think critically to solve problems
- Advance knowledge of the rules and regulations set by each state and department operating guidelines, ensuring reserve practices per Self-Insured Plans
- Responsible for assessing claim files and managing incidents with excess coverage exposure
- Evaluate claim files for timeliness, accuracy, and action planning that will bring files to successful and cost-effective resolution
- Develop and implement strategic program goals, targeting workers compensation metrics across all operating business segments
- Responsible for reviewing and analyzing all workers' compensation claims documents; investigates and evaluates all claims with new or omitted medical condition submissions for compensability within statutorily required time limits; approves or denies claims; establishes claims reserves and negotiates claims resolutions and settlements within assigned limits; recommends and/or implements settlement offers
- Implements claims cost control measures; reviews medical bills, authorizes payments; reviews and authorizes time loss records; identifies and pursues potential cost recovery from third parties; investigates suspected claims fraud; refers claimants to private rehabilitation organizations
- Assesses and promotes early return to work and light duty options for injured workers; consults with physicians and rehabilitation professionals to identify medical conditions and physical limitations/restrictions; coordinates with departments to determine if work duties can be adjusted to accommodate injured workers on a permanent or temporary basis; monitors light-duty work assignments, maintains required documents and requests reimbursement from Employer
- Calculates employee average weekly wage and determines medically authorized disability payments; coordinates time sheet entries and applicable information with Payroll; issues timely Notice of Closures or permanent disability payments as required
- Assigns claims to defense counsel as appropriate; coordinates with Company Counsel and/or outside legal counsel on litigation of claims; collaborates and prepares litigation strategies with counsel to properly defend the case; attends litigation hearings; identifies and evaluates cases for exposure and potential settlement
- Provides guidance to supervisors and employees related to the workers' compensation claim process; counsels supervisors and employees about return to work and light duty options
- Responsible for maintaining relationships with the medical community to raise awareness of the Company's light duty programs; provides resources such as medical care locations, work release forms and other pertinent information to employees and supervisors in a variety of forums for easy access
- Compiles and completes required workers compensation forms and reports; completes and distributes appropriate forms and correspondence
- Participates in Risk Management strategic planning efforts and budgeting process relative to Company Risk and Safety programs, services, projects or issues under consideration; assists with preparation of annual budgeting process for workers compensation by monitoring claims activity and costs; prepares reports for the Risk Manager regarding projections for reserves
Retailer of officially licensed sports merchandise
Fanatics mission is to facilitate sports community through apparel. The company is one of the largest retailers of officially licensed sports merchandise.
- Work Life Balance - At Fanatics we place our focus on results and empowerment and encourage you to enjoy your time on and OFF the field with our competitive time off policies.
- Recognition and Rewards Program - Fanatics values our internal fans too! Our programs are designed to thank and reward Fanatics athletes for their hard work and commitment to winning as a team.
- Company Sponsored Events - From breakfast to happy hour and every hour in between – Fanatics employees can enjoy time together at one of our many company events.
- Fanatics.com Employee Discount - As an employee you will receive a special discount on all of your favorite sports merchandise and memorabilia.
- Give Back - Fanatics cares about the fans around us. We encourage you to partner up with your teammates in giving back and serving the communities where we work and play.
- Meet & Greets - You never know who will show up to the office. You might just meet one of your all-time favorite athletes.
- Invest in You - Here at Fanatics we want you to accomplish your goals. We offer tuition reimbursement.
- Healthy Lifestyle - Fanatics cares about helping and supporting our teams in their busy lifestyles. Through wellness relationships with fitness and weight management partners we are here to support you in whatever your lifestyle goals.
- Wellness Coverage - Your health is important to you – and it’s important to us too! We offer a number of benefit plan options for convenience and flexibility.
- Financial Security - Through our plans, Fanatics offers you a way to budget for health care expenses that you’d typically pay for out of pocket.
- Retirement - The sooner you begin planning for your retirement, the better. Fanatics offers generous plans to help you prepare for the future.
- Network of Support - Fanatics understands that sometimes you may need someone in your corner. Through the Life Assistance Program, you and your family have access to support 24 hours a day, 7 days a week.
- Fanatics Family First - Afterall we are #OneFanatics. Put your family first with our paid maternity and paternity leave program, or take advantage of our infertility treatment reimbursement program to get the support you need while you try to grow your family.
- IDEA - We invite you to join one of our Employee Resource groups, or celebrate and honor what’s most important to you through our IDEA (Inclusion, Diversity, Equality & Advocacy) floating holiday. We recognize diversity helps foster innovation, and people perform better when they can be themselves. Gender Affirmation Treatment reimbursement is available to employees.
- By Fans, For Fans - By Fans = Bringing passion and pride to the work we do; For Fans = Exceeding fan expectations
- One Fanatics... Win As A Team - Our combined efforts; growing and succeeding together; WE before ME
- Missionary, Not Mercenary - At Fanatics, working here is more than a paycheck, it’s doing what you love everyday
- Innovative Products and Fan Experiences - Offering fans unique products and ultimate experiences – there is no one else doing what we do, better than we do it
- Execution and Agility... Over Talk - Quickly adapting and delivering our best in a fast-paced, high growth environment while maintaining humility